CENTERS FOR MEDICARE & MEDICAID SERVICES
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Quick Facts about Medicare's New Coverage
for Prescription Drugs for people who are
Nursing Home residents or live in certain
pes of Long-term Care Facilities
Starting January 1, 2006, Medicare will offer prescription drug coverage for everyone
with Medicare. In order to get Medicare drug coverage, you will need to enroll in a
Medicare prescription drug plan.
What do I need to know?
• You can first enroll in a Medicare prescription drug plan from November 15, 2005
-May 15, 2006. In most cases, if you don't enroll during this period your next
chance to enroll will be November 15, 2006-December 31, 2006, and you may
have to pay a higher premium. You won't have to pay a higher premium if you had
continuous drug coverage from another source that was, on average, at least as
good as standard Medicare drug coverage.
• If you are not able to enroll on your own, your authorized representative can enroll
you in a plan that meets your needs.
• Some nursing homes and other long-term care facilities have their own pharmacy.
• If you move into a nursing home or other long-term care facility, you can switch
Medicare prescription drug plans at that time if you choose to.
• If you are in a skilled nursing home getting Medicare-covered skilled nursing care,
your prescriptions generally will be covered by Medicare Part A.
• There is extra help for people with limited income and resources, including people
who have Medicaid health coverage and people who receive Supplemental Security
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What do I need to know? (continued)
• If you have full coverage from Medicaid, your prescription drugs stop being
covered by Medicaid, and start being covered by Medicare on January 1, 2006.
You will have continuous coverage.
• If you have full coverage from Medicaid and live in a nursing home, you will
pay nothing out of your own pocket.
• If you have full coverage from Medicaid and live in an Assisted Living or Adult
Living Facility, or a Residential Home, you will pay a small copayment for each
covered prescription drug.
How do I get more information?
• Read the "Medicare & You 2006" handbook that you get in the mail in October
• Visit www.medicare.gov on the web. Select "Search Tools" to get personalized
• Call your State Health Insurance Assistance Program (see your copy of the
"Medicare & You 2006" handbook for their telephone number). You can also call
1-800-MEDICARE (1-800-633-4227), or visit www.medicare.gov on the web to
get the telephone number. TTY users should call 1-877-486-2048.
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
• Look for local Medicare-related events.
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CMS Pub. No. 11121